| NPI | 1689113276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY JEAN GUZOWSKI CEO 814-881-6623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA 30943601) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2023-01-10 |